Research Program Area: Health & Exposure
The lungs from youths 14 to 25 years of age, who were killed in vehicular accidents or by homicide, were the central part of a feasibility demonstration study. The specific goals were to accession lungs at autopsy, test special pathologic methodologies, search for early lesions of destructive lung disease, and assess the availability of demographic and air pollution data. Feasibility was demonstrated for the pathologic study in that 107 of 117 lungs meeting the selection criteria were accessioned, processed and analyzed. Methodologies successfully applied included a perfusion-inflation apparatus for multiple-lung and multiple-day fixation, image analysis for the quantitation of bronchial submucosal glands (mucus content and gland structure), and rotary electrical slicing for whole lung gross evaluation of disease in genera1 and emphysema in particular. The emphysema methodology proved to be insufficiently sensitive for optimal detection and measurement, but we successfully substituted a sledge microtomediazo replication technique. Lung elastin quantitation was not feasible with the available analyzer; a replacement analyzer with a true color detector is needed. The fluorescent antibody cell sorter for the quantitation of lymphocyte subpopulations (lung hilar nodes) achieved some degree of successful labeling, i.e. 59 of 67 cases (88%). The demographic study was limited by early complications in the letters of introduction, interview protocols, and interviewer assignments. Feasibility of next-of-kin interviews was in large part demonstrated at the end of the study period as new data sources were identified. However, only limited demographic data were obtained on 29 cases (1987-1989) randomly selected. Of the 29 cases, 11 next-of-kin individuals were contacted and of these 60% were successfully interviewed. A protocol for obtaining blood samples was effected and specimens from 30 cases have been made available for cotinine and cannabinoid tests. Slight to moderate degrees of centriacinar region (CAR) chronic inflammation were found in 51 (48%), and the inflammation was severe and extensive in 29 (27%), with the 27 remainder having minimal or no inflammation (25%). Of the 29 with severe CAR disease, 14 were listed as residents of Los Angeles, 7 were from other cities in Los Angeles County, and the records immediately available (Case Reports) for 8 did not list residence. A definitive study of present and prior residences is a part of an ongoing demographic study. Chronic bronchitis was present in 112 of the 117, and did not parallel the extent and severity of CAR disease. These preliminary findings, when added to the general literature on the adverse effects of air pollution, indicate a strong potential for the use of human pathologic studies in the evaluation of community air quality.
For questions regarding this research project, including available data and progress status, contact: Research Division staff at (916) 445-0753
Stay involved, sign up with CARB's Research Email Distribution List